1. Treatment of Clients Experiencing Pain Disorders
A Collaborative Approach to Care
June 2, 2018 * Tex-CHIP Training Series

2. Role of Nutrition & Lifestyle in Prevention/Management of Pain Disorders

3. Understanding Provider Role in Treating Pain Disorders
Each food choice either increases or decreases inflammation
Assess diet pattern in patient
Individualization
Maintain or lose weight
Restriction and/or Avoidances High Inflammatory Foods:
Dairy
Grains/Gluten
Soy
Refined Carbohydrates
Saturated Fats
Excess consumption omega-6s
Monosodium glutamate (MSG)
Excess consumption omega-6s can trigger the body to produce pro-inflammatory chemicals. These fatty acids are found in oils such corn, safflower, sunflower, grapeseed, soy, peanut, and vegetable; mayonnaise; and many salad dressings.
Cytokines processed sugars trigger the release of inflammatory messengers called.

4. Considerations when Interacting with Clients
Depression
Multiple autoimmune diseases causing chronic inflammation and pain:
lupus
rheumatoid arthritis
celiac disease
psoriasis
irritable bowl disease
Weight gain (depression, coping mechanisms)
Alcohol consumption
Medication interactions
B12 deficiency and metformin
methotrexate – reduces absorption of folic acid , can altered taste, cause nausea, vomiting, diarrhea

5. Our Treatment Plan Healthcare Domain: Nutrition Provider: Dietitian
Objective:
Provide alleviation of presenting trauma symptoms as indicated by client report of:
(a) Inflammation – internally or externally
(b) Gastrointestinal irritation
(c) Overweight/Obesity
(d) Depression   
Goals:
a)  Identify food group(s) causing inflammation to patient
b) Decrease consumption processed foods, increase consumption of vegetables and fruit (individualized goal for amount)
c)  Reduce weight 7-10% if overweight or obese (BMI <30).
Interventions:
a)  Eliminate entire food group (i.e. dairy, gluten) focusing on one at a time for 3 weeks. Then reintroduce food group for 1-2 weeks.
b)  Follow vegetarian, vegan or Mediterranean meal pattern.
 c) Engage in physical activity 30 minutes each day.

6. Measuring Outcomes/ Success
Identifying food group(s) that worsen symptoms successfully through elimination diet
If chronic inflammatory disease, reduction of symptoms from diet
Decrease in processed foods consumed
Increase in vegetables and fruits consumed
Weight loss (7-10%)
Consistent exercise – 30 minutes every day

7. Communication from Counselors
Report patient coping techniques (i.e. marijuana use, alcohol, sweets)
Diet quality
Living arrangements
Mobility to shop/cook food
Food security status/socio-economic